Step 16 of 23 · Before your first client

Telehealth and state lines

Video makes it feel as if the therapy room has no address. Legally it has one: wherever the client is sitting. Here is how that rule works, what the counseling, psychology and social work compacts do as of October 2026, and what to do when a client travels or moves.

Reviewed by Albert Wong, PhDClinical psychologistLast reviewed October 2026About this site

All 23 steps

An illustrated valley of patchwork fields divided by a winding river, with a small lit cottage on each bank joined by a faint dotted line of light. — Two homes, two jurisdictions, one conversation. The line of light crosses the river easily; the license that makes it lawful has to be valid on the far bank.

Key terms on this page (6)

Telehealth: Therapy by live video or phone. Same profession, same ethics, same law as in person, plus a few extra duties.
Interstate compact: A law passed in the same form by several states so that a license in one member state can be used in the others.
Privilege to practice: The Counseling Compact’s authorization to practice in another member state, issued on top of your home-state license.
Home state: In the compacts, usually the member state where you live and hold your primary license.
Licensure by endorsement: A faster route to a license in a new state for clinicians already licensed somewhere else. Rules vary by state.
Temporary practice allowance: Permission some states give out-of-state licensees to see a client there for a short time, usually an existing client.

The rule: where the client is sitting

Licenses are issued by states, and states regulate the care their residents and visitors receive. When you see a client by video, the session happens, legally, where the client is. A therapist in Ohio talking to a client who is on a work trip in Colorado is practicing in Colorado for that hour.

You

Licensed in state A

At your desk, on a video call.

Your client

Sitting in state B

State B’s law applies to the session.

Four lawful ways to keep working with them

A license in the client’s stateAlways works. Apply by endorsement if you are already licensed elsewhere.
A compact privilegeOnly if your license and both states are in the same compact, and it is issuing.
A temporary allowance or telehealth registrationSome states offer one, with strict limits on days or clients.
Refer or pauseHelp the client find a clinician licensed where they are, and plan the handoff.

Where you are sitting matters less than where the client is. A session with a client in another state, without one of these, is generally practicing without a license there.

This is why telehealth intake forms ask for the client’s address, and why it is good practice to confirm and note the client’s location at the start of every session. It also matters in an emergency: you need to know where to send help.

The compacts, as of October 2026

Interstate compacts are the long-term answer to the patchwork. Each one is a law that states pass in identical form, with a commission that runs it. They are moving at different speeds:

Psychologists: Live
PSYPACT, in about 43 jurisdictions. Covers telepsychology, plus limited temporary in-person practice. California and New York are among the large states not in it.
Counselors: Live in 11 states
The Counseling Compact issues privileges to practice in Arizona, Arkansas, Georgia, Indiana, Louisiana, Minnesota, Missouri, Ohio, Oklahoma, Tennessee and Wyoming. Most other member states are still completing the steps.
Social workers: Enacted, not issuing
The Social Work Licensure Compact has passed in more than 30 states but is not issuing multistate licenses yet, and has set no firm start date.
MFTs: None
No interstate compact for marriage and family therapists.

Three things hold for every compact. They cover fully licensed clinicians only, never associates. You practice under the law and scope of the state where the client is, which can differ from your home state. And a compact privilege depends on your home license staying in good standing: discipline in one state follows you to the others.

Check your own situation

Three questions, a general answer. Nothing here is saved or sent, and it is not legal advice.

Question 1

Where are you in your career?

Question 2

Where is the client sitting during the session?

Question 3

Which license do you hold, or are working toward?

Short-term options some states offer

Without a compact, some states provide a narrower door. They differ widely, so treat these as examples, not a rule:

Temporary practice for an existing client (California). A counselor, MFT or clinical social worker licensed in another state can apply to the California board for up to 30 consecutive days in a calendar year to see a client who was already theirs and is traveling to or relocating in California. You apply and get approval before the first session.
Telehealth registration (Florida). Florida lets some out-of-state health professionals register to provide telehealth to patients in Florida without a full Florida license, within limits set in state law.
Licensure by endorsement. Many states have a faster route for clinicians already licensed elsewhere. It takes weeks to months, so it suits a client who is moving for good, not one on vacation.

Your own board and the board in the client’s state are the only reliable sources. Start from the requirements pages or the state map, and follow the board links.

Three situations you will meet

Invented composites, not real people.

Lena

LPC in Ohio

Compact privilege

A long-term client took a job in Indiana. Both states issue Counseling Compact privileges, so Lena applied for one in Indiana and kept working with her after the move.

Marcus

AMFT in California

Paused, then referred

A college student client went home to Oregon for the summer. As an associate Marcus had no way to practice there, so with his supervisor he planned a pause and offered referrals for the summer.

Dr. Okafor

Psychologist in Texas

PSYPACT

She sees clients across several PSYPACT states by video. Each session note records where the client was, and she keeps a list of local crisis numbers for each state.

Myths worth dropping

Myth

“If I’m licensed where I live, I can see anyone by video.”

Actually

The client’s state governs the session. Your home license alone covers clients in your home state.

Myth

“The compacts mean a national license.”

Actually

Each covers some states, one profession, and only fully licensed clinicians. The MFT profession has none.

Myth

“A client on vacation is fine for a session or two.”

Actually

Sometimes, if that state allows temporary practice. Many don’t. Check before the trip.

Next · Step 17

Practicum and internship

Part 4 begins with your first clients: how to find a practicum site that fits, whether it should pay you, the insurance you need, and how to get the most from supervision.

Continue Back to all 23 steps

Questions people ask

Can a therapist see a client in another state over video?

Only with legal authority to practice in the state where the client is located during the session. That can be a license in that state, a compact privilege, or a temporary allowance or telehealth registration where the state offers one. Otherwise the usual answer is to refer the client to someone licensed where they are.

Does the Counseling Compact let me practice in every state?

No. As of October 2026 the Counseling Compact issues privileges to practice in 11 states, and only to counselors who hold a full, unrestricted license in a member state where they live. Many more states have enacted it and are still completing the steps to go live. Check the commission’s site for the current list.

Can associates or pre-licensed therapists use the compacts?

No. Every compact covers fully licensed clinicians only. While you are an associate or trainee you can generally see clients only in the state that registered you, under your supervisor, and only where your registration and your site allow telehealth.

What if my client is on vacation in another state?

The session is governed by the law of the state they are visiting. Some states allow a short period of temporary practice for an existing client; California, for example, has a 30-day allowance that you must apply for before the session. Others do not. Check the rule before the trip, not during it.

Is there an interstate compact for marriage and family therapists?

Not as of October 2026. An MFT who wants to see clients in another state needs a license there, or that state’s temporary allowance if it has one.

Sources

Checked 28 October 2026. Compacts change quickly; check the commission’s own site and both state boards before you rely on them.

Counseling Compact Commission — The 11 states now issuing privileges to practice (Missouri live 19 October 2026) and the states still completing the steps.
PSYPACT — Participating jurisdictions, telepsychology authority and temporary in-person practice.
ASPPB, E.Passport — The credential psychologists hold to practice telepsychology under PSYPACT.
Social Work Licensure Compact — Enacted in member states; multistate licenses not yet being issued.
California Board of Behavioral Sciences, Temporary practice allowance FAQ — Up to 30 consecutive days per calendar year for an existing client located in California; apply before services begin.
California Business and Professions Code §4980.395 — Three hours of telehealth coursework, including law and ethics, for MFT applicants (parallel rules for counselors and clinical social workers).
Florida Statutes §456.47, Use of telehealth to provide services — Registration for out-of-state health care professionals to provide telehealth to patients in Florida.
HHS, HIPAA and telehealth — Privacy and security duties for telehealth, and the end of the pandemic enforcement discretion in 2023.
SAMHSA, 988 Suicide and Crisis Lifeline — Call, text or chat 988 anywhere in the US.

Track your hours, free

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Start free with Practice Harbor All requirements

General information, not legal advice. Requirements are summarized from each state’s licensing board, statutes and regulations on the date shown; the board decides, and rules change. Becoming Licensed is not affiliated with any licensing board.